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首页> 外文期刊>Journal of Oral and Maxillofacial Surgery >Using an In-House Approach to Computer-Assisted Design and Computer-Aided Manufacturing Reconstruction of the Maxilla
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Using an In-House Approach to Computer-Assisted Design and Computer-Aided Manufacturing Reconstruction of the Maxilla

机译：利用内部探讨夹具的计算机辅助设计和计算机辅助制造重建

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PurposeComputer-assisted design (CAD) and computer-aided manufacturing (CAM) techniques are in widespread use for maxillofacial reconstruction. However, CAD/CAM surgical guides are commercially available only in limited areas. To use this technology in areas where these commercial guides are not available, the authors developed a CAD/CAM technique in which all processes are performed by the surgeon (in-house approach). The authors describe their experience and the characteristics of their in-house CAD/CAM reconstruction of the maxilla. Patients and MethodsThis was a retrospective study of maxillary reconstruction with a free osteocutaneous flap. Free CAD software was used for virtual surgery and to design the cutting guides (maxilla and fibula), which were printed by a 3-dimensional printer. After the model surgery and pre-bending of the titanium plates, the actual reconstructions were performed. The authors compared the clinical information, preoperative plan, and postoperative reconstruction data. The reconstruction was judged as accurate if more than 80% of the reconstructed points were within a deviation of 2?mm. ResultsAlthough on-site adjustment was necessary in particular cases, all 4 reconstructions were judged as accurate. In total, 3?days were needed before the surgery for planning, printing, and pre-bending of plates. The average ischemic time was 134?minutes (flap suturing and bone fixation, 70?minutes; vascular anastomoses, 64?minutes). The mean deviation after reconstruction was 0.44?mm (standard?deviation, 0.97). The deviations were 67.8% for 1?mm, 93.8% for 2?mm, and 98.6% for 3?mm. The disadvantages of the regular use of CAD/CAM reconstruction are the intraoperative changes in defect size and local tissue scarring. ConclusionGood accuracy was obtained for CAD/CAM-guided reconstructions based on an in-house approach. The theoretical advantage of computer simulation contributes to the accuracy. An in-house approach could be an option for maxillary reconstruction.
机译：PurposeComputer辅助设计（CAD）和计算机辅助制造（CAM）技术对于颌面重建广泛使用。然而，CAD / CAM外科手术指南仅在有限区域商业上可用。在这些商业指南不可用的区域中使用这项技术，作者开发了一种CAD / CAM技术，其中所有流程由外科医生（内部方法）进行。作者描述了他们的经验和他们内部CAD / Cam重建颌面的特征。患者和方法是回顾性研究上颌重建，具有自由骨皮皮瓣。免费CAD软件用于虚拟手术，并设计由三维打印机印刷的切割导轨（上颌骨和腓骨）。在模型手术和钛板预弯曲后，进行实际重建。作者比较了临床信息，术前计划和术后重建数据。如果重建点的超过80％的重建点在2Ωmm的偏差范围内，重建被判断为准确。结果虽然在特定情况下是必要的现场调整，但所有4个重建都被判断为准确。总共需要3个？在手术前需要进行策划，印刷和平板预先弯曲的手术前。平均缺血时间为134分钟（皮瓣缝合和骨固定，70？分钟;血管吻合，64分钟）。重建后的平均偏差为0.44ΩΩmm（标准？偏差，0.97）。偏差为1Ωmm，2μmm，93.8％，3Ωmm，98.6％。经常使用CAD / CAM重建的缺点是缺陷尺寸和局部组织瘢痕的术中变化。结论基于内部方法的CAD / CAM引导重建获得了精度。计算机模拟的理论优势有助于准确性。内部方法可以是上颌重建的选择。

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    Toshiaki Numajiri; Daiki Morita; Hiroko Nakamura; Shoko Tsujiko; Ryo Yamochi; Yoshihiro Sowa; Kenichiro Toyoda; Takahiro Tsujikawa; Akihito Arai; Makoto Yasuda; Shigeru Hirano;

  • 作者单位

    Department Head and Associate Professor Department of Plastic and Reconstructive Surgery Kyoto;

    Department of Plastic and Reconstructive Surgery Kyoto Prefectural University of Medicine;

    Department of Plastic and Reconstructive Surgery Kyoto Prefectural University of Medicine;

    Department of Plastic and Reconstructive Surgery Kyoto Prefectural University of Medicine;

    Department of Plastic and Reconstructive Surgery Kyoto Prefectural University of Medicine;

    Department of Plastic and Reconstructive Surgery Kyoto Prefectural University of Medicine;

    Department Head Otorhinolaryngology Kyoto City Hospital;

    Department of Otorhinolaryngology Kyoto Prefectural University of Medicine;

    Department of Otorhinolaryngology Kyoto Prefectural University of Medicine;

    Department of Otorhinolaryngology Kyoto Prefectural University of Medicine;

    Department Head and Professor Department of Otorhinolaryngology Kyoto Prefectural University of;

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  • 中图分类 口腔科学;
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